Provider Demographics
NPI:1689125494
Name:KELLEY UNIDAS INC.
Entity Type:Organization
Organization Name:KELLEY UNIDAS INC.
Other - Org Name:FAITH, HOPE & CLARITY COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MENTAL HEALTH PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP, LPC, LADC
Authorized Official - Phone:402-310-0115
Mailing Address - Street 1:236 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-1309
Mailing Address - Country:US
Mailing Address - Phone:402-310-0115
Mailing Address - Fax:402-477-4247
Practice Address - Street 1:2645 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1340
Practice Address - Country:US
Practice Address - Phone:402-310-0115
Practice Address - Fax:402-277-4247
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KELLEY UNIDAS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty